Asymmetric Cerebral Perfusion in Comatose Extracorporeal Membrane Oxygenation Patients

Asymmetric cerebral perfusion can occur when extracorporeal membrane oxygenation (ECMO) flow competes with native cardiac circulation. It is unclear whether this phenomenon associates with brain injury. Diffuse correlation spectroscopy (DCS) provides continuous, laser-based, non-invasive, bedside monitoring of relative cerebral blood flow (rCBF). This study measured rCBF in ECMO patients via DCS to determine whether comatose patients experience asymmetric cerebral perfusion. Adults receiving ECMO for any indication were prospectively recruited from 12/2019-3/2021. Patients with prior neurologic injury, scalp/facial lacerations, and SARS-CoV-2 infection were excluded. DCS monitoring was performed daily during ECMO support with sensors placed on bilateral foreheads. Mean arterial pressure (MAP) was continuously recorded from the bedside monitor. The Glasgow Coma Scale (GCS) was assessed by clinical staff multiple times daily with sedation pauses, if possible, per standard of care. rCBF was calculated by comparing continuous cerebral blood flow (CBF) measurements to the daily median CBF, then averaged at each MAP value. Daily rCBF asymmetry was calculated by summing the absolute difference of rCBF between the two hemispheres at each MAP value, normalized for the total MAP range experienced by the patient that day. Twelve subjects were enrolled in this study (ages 21-78, 6 with cardiac arrest, 4 with acute heart failure, 2 with ARDS) and grouped by maximum GCS motor (GCS-M) score during ECMO, with 3 "comatose" subjects (GCS-M <= 4), and 9 "awake" subjects (GCS-M > 4). DCS was performed over 66 sessions with a mean duration of 131.83 +/- 1.13 minutes. Comatose subjects exhibited more rCBF asymmetry than awake subjects (0.28 +/- 0.06 mmHg-1 vs. 0.10 +/- 0.001 mmHg-1, p=0.045). No difference in asymmetry was noted between patients with or without cardiac arrest. We found that comatose ECMO subjects exhibited higher inter-hemispheric rCBF asymmetry over a range of blood pressures than awake subjects. Though our comatose sample is small, further validation of this finding and its causes, such as cerebrovascular dysregulation, is warranted.

Evaluating the spread of Omicron COVID-19 variant in Spain

This work analyzes the propagation of Omicron, a high transmissible COVID-19 variant, across Spain by means of EpiGraph. EpiGraph is an agent-based parallel simulator that reproduces the COVID-19 propagation over wide areas. In this work we consider a population of 19,574,086 individuals related to the 63 most populated cities of Spain for the time interval comprised between May 15th of 2021 and March 6th of 2022. The main variants existing at the start of the simulation were the Alpha and Delta, with a a 4% and 96% prevalence of the existing infections, respectively. Then, during the second mid of November of 2021 the Delta variant appears in Spain. Given to the higher transmission of this new variant-about 2 times larger than Delta-, it quickly spreads through all the cities and becomes the dominant strain of the country. In this work we analyze the propagation of this variant under multiple conditions. First, we define a baseline scenario, that reproduces the existing conditions of the COVID-19 propagation in Spain for this period. Then, we consider alternative scenarios, in which different locations of the initial spread of Omicron variant are considered. Finally, for each one of these scenarios, we evaluate different transportation intensities-i.e. movement of individuals between the cities-. The main conclusion of this work is that, independently of the initial location of the Omicron variant, and the existing transportation conditions, the Omicron variant spreads though all the country in a short time interval. © 2022 IEEE.

Data Management in EpiGraph COVID-19 Epidemic Simulator

The transmission of COVID-19 through a population depends on many factors which model, incorporate, and integrate many heterogeneous data sources. The work we describe in this paper focuses on the data management aspect of EpiGraph, a scalable agent-based virus-propagation simulator. We describe the data acquisition and pre-processing tasks that are necessary to map the data to the different models implemented in EpiGraph in a way that is efficient and comprehensible. We also report on post-processing, analysis, and visualization of the outputs, tasks that are fundamental to make the simulation results useful for the final users. Our simulator captures complex interactions between social processes, virus characteristics, travel patterns, climate, vaccination, and non-pharmaceutical interventions. We end by demonstrating the entire pipeline with one evaluation for Spain for the third COVID wave starting on December 27th of 2020. © 2022, Springer Nature Switzerland AG.

Synthesis of antimicrobial benzimidazole-pyrazole compounds and their biological activities

The synthesis of new compounds with antimicrobial and antiviral properties is a central objective today in the context of the COVID-19 pandemic. Benzimidazole and pyrazole compounds have remarkable biological properties, such as antimicrobial, antiviral, antitumor, analgesic, anti-inflammatory, anti-Alzheimer's, antiulcer, antidiabetic. Moreover, recent literature mentions the syntheses and antimicrobial properties of some benzimidazole-pyrazole hybrids, as well as other biological properties thereof. In this review, we aim to review the methods of synthesis of these hybrids, the antimicrobial activities of the compounds, their correlation with various groups present on the molecule, as well as their pharmaceutical properties.

Jigsaw in the time of pandemic

Based on our positive, but limited experience with Jigsaw at the university level, half a year ago we initiated a more extensive experiment with a larger sample of students, and incorporating changes that relate back to some negative comments we have received during the previous course. Jigsaw is a collaborative inquiry-based learning technique that works by dividing the learning material into different tasks and the class into different groups. What set out to be a controlled experiment in increasing motivation and participation through collaboration, turned into a much more complex scenario due to the arrival of the Covid-19 pandemic, which gave us some interesting results to report. We have seen more positive results this year than the last: the number of students that felt that Jigsaw requires more effort than traditional methods has fallen, they consistently thought that Jigsaw improved teamwork, and they felt they have learned more from their expert peers as the experiment advanced. Some of the results may be due to the confinement forcing people stay indoors, with no social outings and fewer distractions - so more time to study. Another factor that may be relevant are the implicit expectations that were set by the confinement about distance learning and the need to cooperate. © 2020 17th International Conference on Cognition and Exploratory Learning in Digital Age, CELDA 2020. All rights reserved.